A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's death. Which of the following ethical principles should the nurse use to support the decision not to administer the medication?

Answer: D

Rationale:

A. The American Hospital Association requires accredited facilities to have protocols in place requiring medication reconciliation: The American Hospital Association does advocate for medication reconciliation as part of safety protocols, but the primary focus of medication reconciliation is not solely based on AHA requirements. It is more about improving patient safety and preventing errors.

B. The nurse who performs medication reconciliation is demonstrating the ethical principle of veracity: While medication reconciliation involves accurate and truthful communication, it primarily serves to ensure safety and accuracy in medication management rather than directly demonstrating the ethical principle of veracity.

C. The International Council of Nurses Code of Ethics stipulates that the nurse performs medication reconciliation when a client is admitted to a facility, is transferred to another facility, and when a client is discharged from a facility: Although medication reconciliation is crucial at these points of care transition, the International Council of Nurses Code of Ethics does not explicitly mandate this process.

D. The purpose of medication reconciliation is to prevent adverse medication reactions: Medication reconciliation aims to ensure accurate medication lists and prevent errors, which in turn helps prevent adverse medication reactions. This aligns with the primary goal of the process, which is to enhance medication safety.

A. Increase hematocrit: Fluid overload typically leads to hemodilution, resulting in a decrease in hematocrit rather than an increase. Therefore, an increase in hematocrit would not be expected in a client with fluid overload.
B. Increased temperature: Fluid overload is not typically associated with an increased body temperature. Instead, fever may indicate an infection or another underlying cause. Therefore, an increased temperature would not be a typical finding in a client with fluid overload.
C. Increased heart rate: Fluid overload can lead to an increased heart rate as the body attempts to maintain adequate cardiac output in the presence of excess fluid volume. An elevated heart rate is a compensatory mechanism to maintain tissue perfusion despite the increased workload on the heart.
D. Increased respiratory rate: Fluid overload can cause pulmonary congestion, leading to increased respiratory effort and a higher respiratory rate as the body attempts to compensate for decreased gas exchange efficiency. An increased respiratory rate helps to improve oxygenation and remove excess carbon dioxide from the body.
E. Increased blood pressure: Fluid overload often leads to increased blood pressure due to the increased volume of circulating blood, which can strain the cardiovascular system. Elevated blood pressure is a common manifestation of fluid overload and reflects the increased workload on the heart and blood vessels.